Letter From the President

by Tim McMahon

The presents have long since been unwrapped, the incessant line-up of Holiday television favorites are over (for another year) and the BCS has left us with co-national champions in college football (something that wasn’t supposed to happen). Thank you notes have been sent (well most of them anyway), the ball has dropped ushering in the New Year and the Holiday “lag time” (you know, those two weeks where nothing seems to get done) is now behind us. It is back to reality time.

Reality smacked me square between the eyes in two different situations the other day that foretells how 2004 will play out for most cancer program administrators. Both reflect the ever-changing dynamics of cancer care. The technological advances, emotional component, the financial and reimbursement challenges and the impact our decisions have (or will have) on how services will be delivered in the future.

The first situation involved a conversation I had with a Medical Oncologist shortly before the Holidays. He has been practicing in our community for more than 15 years in a solo practice (an enigma in this day and age) and is highly regarded by patients for his compassion. He knocked on my office door, poking his head in to say that during a recent review of his practice that the new Medicare payments for outpatient chemotherapy will result in him probably closing his practice. After a brief conversation, he said he would make his final decision sometime during 2004. This comes on the heels of losing two other Medical Oncologists during 2003. Some people are already waiting 4-5 weeks for a new patient appointment in some offices. While that may be an acceptable wait time for some of your settings, this is a new phenomenon here, and most patients and referring physicians are having a difficult time adjusting to it.

The other situation involved me helping someone out of his car. I was walking into the Powell Cancer Center after a meeting at the hospital. A woman was struggling to help a man into a wheelchair. I stopped and helped, then stayed with this gentleman while his daughter went to park the car. During the ensuing conversation, I leaned that this gentleman, in his mid 40s, had been diagnosed with colorectal cancer 14 months ago. During that time he has had surgery twice, one course of radiation therapy and he was set to begin a third chemotherapy regimen that day.

In his voice I heard hope and optimism, in his eyes I saw fear and despair. He talked with me about the drain his illness has had on the family’s financial situation and how the fatigue has left him feeling a shell of his former self. His wife and he both had been using the counseling provided by our cancer program and he did say that it was helping, but he didn’t know how much longer he wanted to continue, in his words, “feeling crappy”. At that point his wife returned from parking the car and I walked with them to the elevator, wishing them both my best as the doors closed.

When I returned to my office, I sat at my desk feeling drained. Looking at the calendar it struck me; it’s almost time for the ACE Annual Conference. I look forward to this meeting as a time to share information with colleagues and gain new insight into what others are doing to meet the challenges we all face. This year’s conference is shaping up to be the best ever. Kay Petras and the program committee have planned a fantastic group of speakers and topics. I also enjoy reconnecting with colleagues from across the country to share and support each other especially during challenging times like these. I look forward to seeing everyone in Orlando.

Timothy McMahon

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